1. Lisa Lott
   Posted 3 months ago #
   

   A patient came in to see the general surgeon on 12/06/11 and had a unilateral duplex scan of the extremities (CPT code 93971). The patient came back into his office on 01/03/12. Would she be considered an new patient or established patient?
   *Please note that an office visit was not billed on 12/06/11.
   Thank you.

2. SuperCoder
   Posted 3 months ago #
   

   If the scan did not include any face to face time with the surgeon, you can consider the patient new on 93971. If there was face to face time to decide to do the scan but not enough HEM to bill an office visit, I would err that the face to face contact was involved and code established on Jan 3.

   From Part B Insider:
   Interpret the phrase “new patient” to mean a patient who has not received any professional services — in other words, an E/M service or other face-to-face service — from the physician or physician group practice within the previous three years.
   This means that you might be able to report a patient as new if the doctor provided services for the patient less than three years ago — provided it was not a face-to-face-service.
   Example: A patient reports to the physician for an E/M service. The patient’s record indicates that the doctor read the results of the patient’s lab test on May 5, 2009. There was no record of a face-to-face service. You should choose a new patient E/M code for this encounter (99201-99205).
   Explanation: When the physician reads an X-ray, EKG, etc., in the absence of an E/M service or other face-to-face service with the patient, it does not affect the new patient designation.

   Jen Godreau, CPC, CPMA, CPEDC
   Director of Development & Operations
   SuperCoder.com and Coding Institute, LLC

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